Synapse - Outcomes of incidentally detected ovarian cancers diagnosed at time of risk-reducing salpingo-oophorectomy in BRCA mutation carriers

Outcomes of incidentally detected ovarian cancers diagnosed at time of risk-reducing salpingo-oophorectomy in BRCA mutation carriers Journal Article

Authors:	Cowan, R.; Pedra Nobre, S.; Pradhan, N.; Yasukawa, M.; Zhou, Q. C.; Iasonos, A.; Soslow, R. A.; Arnold, A. G.; Trottier, M.; Catchings, A.; Roche, K. L.; Gardner, G.; Robson, M.; Abu Rustum, N. R.; Aghajanian, C.; Cadoo, K.
Article Title:	Outcomes of incidentally detected ovarian cancers diagnosed at time of risk-reducing salpingo-oophorectomy in BRCA mutation carriers
Abstract:	Objective: Prior data suggested that women with incidentally detected occult invasive ovarian cancer (OIOC) at the time of risk-reducing salpingo-oophorectomy (RRSO) for BRCA mutation may have poorer prognoses than would be expected based on disease stage. We sought to evaluate prevalence and outcomes of patients with OIOC in a tertiary referral center. Methods: Patients with BRCA mutation undergoing RRSO from 01/2005 to 05/2017 were identified, and their records reviewed. Women with incidentally detected OIOC were included; those with clinical features raising preoperative suspicion for malignancy were excluded. Results: 548 patients with BRCA mutation who underwent RRSO were identified. 26 (4.7%) had an OIOC (median age 55 years; range 42–75); 15(58%) patients, BRCA1; 9(34%), BRCA2; 2(8%) had a mutation in both genes. All OIOCs were high-grade serous: 10 (38%) Stage I; 8 (31%) Stage II; 8(31%) Stage III. 24(92%) patients received adjuvant platinum/taxane therapy. Of Stage III patients, 4 (50%) were identified intraoperatively; the remaining 4 (50%) had microscopic nodal disease on final pathology only. At median follow-up of 67.3 months (28–166) no Stage I patients have recurred; 2 Stage II and 6 Stage III patients recurred. 5-year progression-free survival (PFS) was 72% (95%CI, 50.2–85.7%); median PFS for the cohort was 129 months (95%CI, 75.3-not estimable). 5-year disease-specific survival (DSS) was 96% (95%CI, 76–99%); median DSS not reached. Conclusion: Consistent with prior reports, almost 5% of patients had an OIOC at RRSO. The majority with early-stage disease had excellent PFS and DSS outcomes, as would be expected based on disease stage. © 2021 Elsevier Inc.
Keywords:	brca; risk-reducing surgery; occult ovarian cancer
Journal Title:	Gynecologic Oncology
Volume:	161
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2021-05-01
Start Page:	521
End Page:	526
Language:	English
DOI:	10.1016/j.ygyno.2021.02.006
PUBMED:	33712278
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102274235&doi=10.1016%2fj.ygyno.2021.02.006&partnerID=40&md5=597d023f75a1a14e723470d58ca4532f
Notes:	Article -- Export Date: 3 May 2021 -- Source: Scopus